Upcoming Classes in 2008:
Sincere thanks to all who came out to the adrenal/thyroid fatigue lecture 5-15-08. Dr. Holthouse
A Word About Probiotics
Friendly bacteria that you can take as a supplement to reduce symtoms for many different conditions such a indigestion, Leaky-Gut Syndrome, autoimmune conditions, antibiotic associated diarrhea illnesses, Irritable Bowel Syndrome, and yeast infections in the gut to name a few. An average adult human carries around 4 lbs of these helpfull hitchickers in the large bowel at any given time. They help us absorb and digest nutrients, are involved with synthesizing certain vital substances we need to be healthy like B vitamins. Recent data shows they even interact with our immune systems to prevent things like Celiac Disease, Multiple Sclerosis, Ulcerative Colitis, Crohn's disease, and arthritis, all of wich we are seeing alot of these days. Our obcession with being "germ-free" in our homes, using antibacterial hand soaps that have now been shown to cause more resistant bacteria, and the indiscriminant use of antibiotics for cold viruses all play a role in losing the bacterial balance.
The reasons many of us end up needing to add "good bacteria" back to our intestines are many. To name a few there are diets high in saturated fat, low in fiber, highly processed foods, high refined white sugar that can destroy the good bacteria. Chronic, unresolved stress can affect our immune systems, alter our gut bacteria, and ultimately cause inflamation in our bodies leading to arthritis, thyroiditis, eczema, and other conditions. Antibiotic use destroys the good along with th bad bacteria in our bowels. This often leads to yeast overgrowth which can inturn cause abdominal bloating, cramping, and inflamation throughout the body.
Experts now feel that no probiotic supplements are likely to be dangerous. The only caveat is that there have been a couple of studies in the 1990's that identified adulteration of probiotic supplements with pathogenic E. Coli. Fortunately, more recent testing of 25 brands by ConsumerLab Inc. did not find any cases of adulteration with pathogenic bacteria.
Regarding the information on probiotic labels, due to lack of effective government regulation, information with regard to potency and expiration date is, unfortunately, not entirely reliable. ConsumerLab tested 25 off-the-shelf products and found that 8 of the products contained less than 1% of claimed number of live organisms, 6 of these 8 contained less than one ten-thousndth of the claimed number of live organisms! Add to this that there is now considerable evidence that different species and strains of bacteria work better for different conditions and you will see that professional guidance is needed in making a selection on how to use these products effectivley.
Probiotics are best taken on a full stomach because the food reduces the acidity in the stomach allowing for safe passage of the supplement into the small bowel where they become useful. Ask us about how to get quality probiotics of the right type, in the right amounts, and for the right conditions... there are many variables to consider
How to Choose a Quality Omega-3 Fish Oil
Because of the widely recognized health-promoting properties of Omega-3 oils, more and more practitioners are recommending supplements like EPA and DHA derived from coldwater fish as a compliment to a daily multivitamin to help offset dietary shortages or balance out over-consumption of omega-6s. Clinical studies have demonstrated that EPA and DHA provide support for numerous aspects of health: Cardiovascular health, nervous system, fetal growth and development, immune health, brain health, gastrointestinal function, and much more. This is a healthy trend ,however, the same concerns that plague everyday fish consumption are shared by fish oil supplements. Toxins and other impurities should be a major concern when chosing an omega-3 oil product . Don't supplement with oils having mixed or "balanced" omega products that contain omega-6 and omega-9. The only omega oils you should be supplementing are omega-3s (DHA and EPA). We get way to much of the other omega oils in our current culture and they are more harmfull than helpfull . Currently, Americans get a ratio of omega-6 to omega-3 of around 20 to 1. Healthy ratios should be closer to 4 to 1 of even 1 to 1. These higher ratios promote inflamation in our joints and can disturb cholesterol balances to name only a few negative effects.
Fish Oil or "Snake" Oil?
Patients have many confusing choices when it comes to fish oil and the different products vary widely with regard to purity, price, and quality. There are alot of claims about purity citing standards from organizations that may not be certifying organizations at all. The International Fish Oil Standards (IFOS), for example, is not a standards setting organization--merely one of many laboratories that conducts third party testing. These many "certifications" and "standards" of purity only serve to add to patiet confusion.
While the words "ultra pure" or "ultra refined" may look good on a label, they're just marketing words, not actual standards of purity. Reputable vendors guarantee the quality and purity of their concentrated oils. True GMP certification requires that the quality and purity of formulas be verified through independent, third-party organizations. Quality vendors will meet the standards set by the International Pharmacopoeia, as well as surpass the quality criteria for the Council for Responsible Nutritions's Omega-3 Monograph. In addition approval by the Global Organization for EPA and DHA (GOED) Omega-3--an international, non-profit trade associaton that is also committed to increasing consumer awareness that not all omega-3 products bring equal benefits.
Those items screened for in quality products include: Heavy metals, PCBs, Organochlorides, Organophosphides, Dioxins, Yeast, Mold, E. coli, Salmonella, Staphylococcus, and others.
What about "pharmaceutical grade" fish oil? There are only three pharmaceutical licensed omega-3 manufacturing facilities in the world--despite the many claims you may see for pharmaceutical grade. The facility where Metagenics formulas are produced is one of these three, and is licensed by the Norwegian Medicines Agency (equivalent to the US Food and Drug Administration).
Most companies claim their fish comes from Norway, (thought to be the purest souce), when in actuality most is shipped for South America instead. Reputable companies get the bovine gelatin for their capsules from contries like New Zealand, where no known cases of "mad cow disease" have been found. Many poor quality products smell and taste very "fishy" and the use of artificial flavors is common to cover up the stench of a poor quality product. The better products are not as fishy tasting or smelling.
A reputable source for accurate tech support on this topic can be found at Metagenics Technical Support 1-800-692-9400. Also ask your health care provider for recommendations on a quality vendor.
What About Bio-Identical Hormones?
The term refers to hormones created by a compounding pharmacy from all natural, non-animal products. The starting substances are usually wild yam or soybeans. Our hormone receptors in the cells of the body are like little locks, each requiring a specific key (hormone) to fit it. If the key is similar but not exact we see side-effects, and even diseases like cancer, Fibrocystic Breast Disease, Endometriosis, headaches, hotflashes, weight gain, sleep problems, water retention, and irregular uterine bleeding, to name a few. Bio-Identical ,or better yet Human-Identical hormones, are the exact same molecular structure to fit our receptor locks. The over-the-counter yam and/or soy products usually aren't as effective because the body doesn't recognize them prior to the compounding process. Compounding pharmacies are federally regulated for quality and safety standards but are by no means all the same. Work with your pharmacist and health care provider to ensure that you are getting what you pay for. Many over-the-counter products have no active ingredients in them. Natural progesterone creams for example often have too few milligrams of hormone or the wrong amount of oil in their base. These companies are accountable to no one for their claims of safety and effectiveness.
In contrast to human-identical hormones, most traditional medical doctors are still using synthetic hormones despite recent large -scale studies showing them to have many dangerous side effects. One such example, Premarin by Wyeth-Ayrest Phamaceuticals Inc. This estrogen is from pregnant mare urine and has very little resemblance to the hormone composition of human estrogen. The human ovary makes estrogen in 3 types: Estrone 3-5%, Estradiol 10-15%, and Estriol 65% in those ratios. Bio-identical hormones mirror this ratio of estrogens. Premarin brand estrogen on the other hand is 50% Estrone. This is important when one understands that Estrone in the human body is the most carcinogenic type. It along with Estradiol (to a much lesser extent) stimulate cell division and tissue growth. When balanced with the right proportions of all 3 estrogens as in bio-identical hormone, this cancer causing situation is largely avoided. Humans are not horses!
As women approach their mid 30's , the rate of progesterone production declines about 120 times faster than does estrogen. The ovarian production of all three hormones: estrogen, progesterone, and testosterone, decreases as women age. This rate of decline is very individualized and often requires the sequential addition of natural hormones as women move from premenopause, to perimenopause, to menopause. Progesterone is known as the "feel good" hormone and because it is the first to start declining many women between 35-45 years of age begin noticing the relative excess of estrogen and it's effects. This is known as Estrogen Dominance, and those who have this situation are not feeling very well. This state leads to conditions like, PMS, irregular periods, poor sleep, weight gain, night sweats, headache, mood swings, carb craving, brain fog, uterine fibroids, Endometriosis, and fibrocystic breasts that are sore. Adding back a small amount of natural progesterone, (usually 25-40mg/day), often greatly alleviates many, if not all , these kinds of issues. These natural progesterones work to maintain bone health, sleep, healthy blood sugar values, a sense of calmness , and balanced cellular division. Synthetic progesterones known as Progestins like, Provera,( medroxy -progesterone acetate), lack many of these estrogen balancing effects.
Not to be left out, testosterone can also be helpful to women and men as they age. These levels also drop with time and if accompanied by symtoms like decreased sex drive, painfull intercourse, decreased stamina, decreased energy, sleep disturbances, and loss of lean muscle mass, can play a vital role in hormonal balance. Testing for these levels should accompany any work up for symtoms like those listed above. Testosterone is available as a cream or gel placed on the skin, depo-shots, or muco-adhesive placed inside the cheek of the mouth.
Advantages of Bio-Identical Hormones
-Topical applications avoid going through the liver as in oral preparations. This allows for direct absorption into the blood stream where hormones can quickly reach the cells they influence.
-Improved safety probable due to the findings in large trials like the Womens Health Initiative and the Nurses Health Study. These government sponsored studies are the biggest of their kind, looking at thousands of women without any pharmaceutical company agenda causing bias to results found. These studies found that women using the synthetic hormones, Premarin and Provera, had significantly elevated risk for breast cancer, heart attack, stroke, and blood clots.
-Relief of debilitating symptoms that greatly affect quality of life.
-Customizable prescriptions depending on the individual needs of the patient. This is best assessed using both salivary testing of hormone levels along with symptoms.
Closing Remarks
Many doctors are unwilling to face the evidence found with synthetics. Some are still using them because of habit. Some do it because they have been brain-washed by the pharmaceutical companies who have been sponsoring their medical education on the topic for the last 35 years. Still others are in denial or just plain never learned the biochemical differences between the two options. My recommendation to you is to work with your provider as long as they are knowledgeable on both sides of the discussion, and willing to look beyond what they learned years ago, seeing the abundance of new information available. Be informed. Don't be intimidated. If you feel there is something out of balance keep pursuing the solution even if it means finding a more informed health care provider on the subject. It can become an ego problem for some providers, and that's a problem for you.
Salivary Hormone Testing
Salivary tests give a better idea for tissue levels of a given sex hormone. Saliva represents the active and available hormone at the cellular level. Blood tests give often misleading information because it is less stable over time, require special handling, and is affected by pH, and protein binding levels at the time of measurement.
-Stress free way to check levels
-Noninvasive (no needles)
-Levels can be checked while on the hormones
-Levels can be checked anytime of the day, month, and anywhere.
-Less expensive & more convenient for doctor and patients. (do at home)
-No special processing like ice packs are required for shipping.
-The hormone levels remain stable in saliva samples much longer than in
blood samples.
-Can send saliva samples via U.S. Mail.
Good Books on the Topic
Lee, John R, M.D., What Your Doctor May Not Tell You About Menopause
Lee, John R, M.D., What Your Doctor May Not Tell You About Breast Cancer
Lee, John R, M.D., What Your Doctor May Not Tell You About Perimenopause
Northrup, Christiane, M.D., The Wisdom of Menopause
Northrup, Christiane, M.D., Women's Bodies, Women's Wisdom
Schwartz, Erika, M.D., The Hormone Solution
Randolph, C.W., Jr., M.D., From Hormone Hell to Hormone Well